Covered Entity Details

DSH270012AK BENEFIS HOSPITALS INC. (Active) - information as of 4/30/2025 10:52:27 PM

Main Details

Name

BENEFIS HOSPITALS INC.

Subdivision Name

Family Practice West Clinic

Type

Disproportionate Share Hospital

Rural

340B ID

DSH270012AK

Medicare Provider Number

270012

Outpatient Facility Provider Number

Additional Details

Current Program Status

Active

Registration Date

10/30/2018

Participating Start Date

1/1/2019

Participating Approval Date

11/19/2018

Last Recertification Date

8/20/2024

Contacts

Authorizing Official

Benefis Hospitals Inc.
bruce eric houlihan, CFO
(406) 455-5483

Primary Contact

Benefis Hospitals Inc
JAMIE Hinzman LEONARD, Pharmacy Director
(406) 455-5434

Addresses

Street Address

1401 25th Street South
1st Floor
Great Falls, MT 59405

Billing Address
Same as Street Address

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History

Comments

Comment	Last Updated On
No records to display.

Medicaid Billing

At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?
Yes

State	Medicaid Number	NPI Number
MT	416793,1780968974	1881650737,1578254942

Shipping Addresses

Same as Street Address

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Carve-In Effective Date	Termination Date	Last Updated On
No records to display.

Parent/Child

340B ID	Hierarchy	Entity Type	Name	Sub Name	Address	City	State	340B Status
DSH270012A	Child	DSH	BENEFIS HOSPITALS INC.	BENEFIS WEST CAMPUS	500 15TH AVE. SOUTH	GREAT FALLS	MT	Terminated
DSH270012AA	Child	DSH	BENEFIS HOSPITALS INC.	Benefis Internal Medicine - Internal Medicine	1401 25th St. South	Great Falls	MT	Active
DSH270012AB	Child	DSH	BENEFIS HOSPITALS INC.	Benefis Urology - Urology	1401 25th St. S.	Great Falls	MT	Active
DSH270012AC	Child	DSH	BENEFIS HOSPITALS INC.	Benefis Physical Medicine (Rehab) - Physical Medicine (Rehab)	500 15th Ave S	Great Falls	MT	Terminated
DSH270012AD	Child	DSH	BENEFIS HOSPITALS INC.	Quick Care	1401 25th Street South	Great Falls	MT	Active
DSH270012AE	Child	DSH	BENEFIS HOSPITALS INC.	Onocology Clinic	1117 29TH ST S	GREAT FALLS	MT	Active
DSH270012AF	Child	DSH	BENEFIS HOSPITALS INC.	BENEFIS SLETTEN CANCER INSTITUTE - Radiation Oncology and Infusion Center	1117 29TH ST S	GREAT FALLS	MT	Active
DSH270012AG	Child	DSH	BENEFIS HOSPITALS INC.	Benefis WOUND CARE CLINIC - WOUND CARE CLINIC	500 15th Ave South	Great Falls	MT	Active
DSH270012AH	Child	DSH	BENEFIS HOSPITALS INC.	Plastic Surgery Clinic	400 13TH AVE S	GREAT FALLS	MT	Active
DSH270012AJ	Child	DSH	BENEFIS HOSPITALS INC.	BENEFIS Pediatrics	2720 10th Avenue South	GREAT FALLS	MT	Terminated
DSH270012AK	Child	DSH	BENEFIS HOSPITALS INC.	Family Practice West Clinic	1401 25th Street South	Great Falls	MT	Active
DSH270012AL	Child	DSH	BENEFIS HOSPITALS INC.	Benefis Neuroscience - Neuroscience	500 15th Ave S	Great Falls	MT	Active
DSH270012AM	Child	DSH	BENEFIS HOSPITALS INC.	Benefis Same Day Orthopedics - Same Day Orthopedics	1401 25th Street South	Great Falls	MT	Active
DSH270012AN	Child	DSH	BENEFIS HOSPITALS INC.	Benefis Hospitals Inc. - Benefis AntiCoag Clinic	1401 25th Street South	Great Falls	MT	Active
DSH270012AP	Child	DSH	BENEFIS HOSPITALS INC.	Benefis Nephrology - Nephrology	1401 25th St. S	Great Falls	MT	Active
DSH270012AQ	Child	DSH	BENEFIS HOSPITALS INC.	BENEFIS HOSPITALS, INC. - Northwest Clinic	25 14TH AVE NW	GREAT FALLS	MT	Terminated
DSH270012AR	Child	DSH	BENEFIS HOSPITALS INC.	BENEFIS HOSPITALS, INC. - Healthplan Clinic	1401 25TH ST S	GREAT FALLS	MT	Active
DSH270012AS	Child	DSH	BENEFIS HOSPITALS INC.	BENEFIS HOSPITALS, INC. - SCI Palliative Care	1117 29th St South	GREAT FALLS	MT	Active
DSH270012AT	Child	DSH	BENEFIS HOSPITALS INC.	Clinic OP Palliative Care - Clinic OP Palliative Care	1401 25th Street South	Great Falls	MT	Active
DSH270012D	Child	DSH	BENEFIS HOSPITALS INC.	BENEFIS PEACE HOSPICE	1501 26TH STREET SOUTH	GREAT FALLS	MT	Terminated
DSH270012F	Child	DSH	BENEFIS HOSPITALS INC.	Benefis Heart and Vascular Institute	1300 28th St S	GREAT FALLS	MT	Active
DSH270012G	Child	DSH	BENEFIS HOSPITALS INC.	Benefis Sletten Cancer Institute - GYN Oncology Office and Infusion Center	1117 29TH ST S	GREAT FALLS	MT	Terminated
DSH270012H	Child	DSH	BENEFIS HOSPITALS INC.	Benefis Bladder and Pelvic Treatment Center	2800 11TH AVE S	GREAT FALLS	MT	Terminated
DSH270012J	Child	DSH	BENEFIS HOSPITALS INC.	Benefis ENT Clinic	1401 25th Street South	Great Falls	MT	Active
DSH270012K	Child	DSH	BENEFIS HOSPITALS INC.	Benefis Neurosurgery - Neurosurgery	1401 25th St. S.	Great Falls	MT	Active
DSH270012L	Child	DSH	BENEFIS HOSPITALS INC.	Orthopedic Clinic	1401 25th Street South	Great Falls	MT	Active
DSH270012M	Child	DSH	BENEFIS HOSPITALS INC.	Benefis Endocrinology	400 13th Avenue South	GREAT FALLS	MT	Active
DSH270012N	Child	DSH	BENEFIS HOSPITALS INC.	BENEFIS PSYCH/CDU - PSYCH/CDU	500 15th Ave South	Great Falls	MT	Terminated
DSH270012P	Child	DSH	BENEFIS HOSPITALS INC.	Benefis Gastroenterology - Gastroenterology	2800 11th Avenue South	Great Falls	MT	Active
DSH270012Q	Child	DSH	BENEFIS HOSPITALS INC.	Pulmonary Clinic	1401 25th St. South	Great Falls	MT	Active
DSH270012R	Child	DSH	BENEFIS HOSPITALS INC.	Benefis Dermatology	400 13TH AVE S	GREAT FALLS	MT	Active
DSH270012S	Child	DSH	BENEFIS HOSPITALS INC.	Benefis Department of Outpatient Surgery - Department of Outpatient Surgery	1401 25th St. S.	Great Falls	MT	Terminated
DSH270012T	Child	DSH	BENEFIS HOSPITALS INC.	Benefis Neurology - Neurology	1401 25th St. South	Great Falls	MT	Active
DSH270012U	Child	DSH	BENEFIS HOSPITALS INC.	Benefis PAIN MANAGEMENT CLINIC / Primary Care Pain Clinic - PAIN MANAGEMENT CLINIC / Primary Care Pain Clinic	500 15th Ave South	Great Falls	MT	Terminated
DSH270012V	Child	DSH	BENEFIS HOSPITALS INC.	Benefis Pain Management - Pain Management	500 15th Ave S	Great Falls	MT	Active
DSH270012W	Child	DSH	BENEFIS HOSPITALS INC.	Benefis Rheumatology - Rheumatology	1401 25th Street South	Great Falls	MT	Active
DSH270012X	Child	DSH	BENEFIS HOSPITALS INC.	Benefis Women's Health	2720 10th Avenue South	Great Falls	MT	Active
DSH270012Y	Child	DSH	BENEFIS HOSPITALS INC.	Benefis Hyperbaric Oxygen Therapy	500 15TH AVE S	GREAT FALLS	MT	Terminated
DSH270012Z	Child	DSH	BENEFIS HOSPITALS INC.	Benefis Infectious Disease - Infectious Disease	1401 25th Street South	Great Falls	MT	Active

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Medicaid Billing	Medicaid: Is Primary	Insert	Group Change Request		False	4/8/2025 5:51 PM
Medicaid Billing	Medicaid: Number	Insert	Group Change Request		1780968974	4/8/2025 5:51 PM
Medicaid Billing	Medicaid: State	Insert	Group Change Request		MT	4/8/2025 5:51 PM
Medicaid Billing	NPI: Number	Insert	Group Change Request		1578254942	9/13/2024 6:45 PM
Medicaid Billing	NPI: State	Insert	Group Change Request		MT	9/13/2024 6:45 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Group Change Request		False	9/13/2024 3:01 PM
Medicaid Billing	Medicaid: Number	Insert	Group Change Request		416793	9/13/2024 3:01 PM
Medicaid Billing	Medicaid: State	Insert	Group Change Request		MT	9/13/2024 3:01 PM
Medicaid Billing	NPI: Number	Insert	Group Change Request		1881650737	9/13/2024 3:01 PM
Medicaid Billing	NPI: State	Insert	Group Change Request		MT	9/13/2024 3:01 PM
Contacts	Authorizing Official	Update	Change Request	Ehlinger, Forrest Chief Financial Officer Benefis Hospitals Inc. 4064555479	houlihan, bruce eric CFO Benefis Hospitals Inc. 4064555483	9/13/2024 2:33 PM
Details	Last Recertification Date	Update	Recertification	9/11/2023 12:03:54 PM	8/20/2024 3:55:30 PM	8/20/2024 3:55 PM
Details	Last Recertification Date	Update	Recertification	8/24/2022 6:14:39 PM	9/11/2023 12:03:54 PM	9/11/2023 12:03 PM
Details	Last Recertification Date	Update	Recertification	9/10/2021 9:31:00 AM	8/24/2022 6:14:39 PM	8/24/2022 6:14 PM
Details	Last Recertification Date	Update	Recertification	9/2/2020 4:27:04 PM	9/10/2021 9:31:00 AM	9/10/2021 9:31 AM
Details	Entity Subname	Update	Recertification	Benefis Family Medicine - Family Medicine	Family Practice West Clinic	9/10/2021 9:31 AM
Details	Last Recertification Date	Update	Recertification	9/16/2019 4:01:43 PM	9/2/2020 4:27:04 PM	9/2/2020 4:27 PM
Details	Last Recertification Date	Update	Recertification		9/16/2019 4:01:43 PM	9/16/2019 4:01 PM
Contacts	Primary Contact	Update	Change Request	Runkel, David Richard Pharmacy Director Benefis Hospitals Inc. 4064555434	LEONARD, JAMIE Hinzman Pharmacy Director Benefis Hospitals Inc 4064555434	7/26/2019 2:39 PM
Contacts	Authorizing Official	Update	Change Request	Olinger, Terry President Benefis Hospitals Inc 4064555477	Ehlinger, Forrest Chief Financial Officer Benefis Hospitals Inc. 4064555479	1/11/2019 9:24 AM
Details	State	Update		Approved	Active	1/1/2019 12:05 AM
Contacts	Signed By	Insert	New Registration		Olinger, Terry President Benefis Hospitals Inc 4064555477	11/19/2018 10:24 AM
Details	340B ID	Update	New Registration		DSH270012AK	11/19/2018 10:24 AM
Details	Entity Subname	Update	New Registration	Benefis Family Medicine	Benefis Family Medicine - Family Medicine	11/19/2018 10:24 AM
Dates	Participating Approval Date	Update	New Registration		11/19/2018 10:24:01 AM	11/19/2018 10:24 AM
Details	State	Update	New Registration	Pending	Approved	11/19/2018 10:24 AM
Dates	Signed By Date	Update	New Registration		10/31/2018 2:35:57 PM	11/19/2018 10:24 AM
Dates	Start Date	Update	New Registration		1/1/2019 12:00:00 AM	11/19/2018 10:24 AM
Addresses	Main Address	Insert	New Registration		1401 25th Street South 1st Floor Great Falls, MT 59405	10/30/2018 11:57 AM
Contacts	Authorizing Official	Insert	New Registration		Olinger, Terry President Benefis Hospitals Inc 4064555477	10/30/2018 11:57 AM
Contacts	Primary Contact	Insert	New Registration		Runkel, David Richard Pharmacy Director Benefis Hospitals Inc. 4064555434	10/30/2018 11:57 AM
Details	Last Recertification Date	Insert	New Registration			10/30/2018 11:57 AM
Details	Grant Number	Insert	New Registration			10/30/2018 11:57 AM
Details	340B ID	Insert	New Registration			10/30/2018 11:57 AM
Details	Is Authorizing Official EHB Data	Insert	New Registration			10/30/2018 11:57 AM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			10/30/2018 11:57 AM
Details	Medicare Provider Number	Insert	New Registration		270012	10/30/2018 11:57 AM
Details	Entity Name	Insert	New Registration		BENEFIS HOSPITALS INC.	10/30/2018 11:57 AM
Details	Program Code	Insert	New Registration		DSH	10/30/2018 11:57 AM
Details	Entity Subname	Insert	New Registration		Benefis Family Medicine	10/30/2018 11:57 AM
Dates	Participating Approval Date	Insert	New Registration			10/30/2018 11:57 AM
Details	State	Insert	New Registration		Pending	10/30/2018 11:57 AM
Dates	Registration Date	Insert	New Registration		10/30/2018 11:57:37 AM	10/30/2018 11:57 AM
Dates	Signed By Date	Insert	New Registration			10/30/2018 11:57 AM
Dates	Start Date	Insert	New Registration			10/30/2018 11:57 AM
Terminations	Termination Comments	Insert	New Registration			10/30/2018 11:57 AM
Terminations	Termination Date	Insert	New Registration			10/30/2018 11:57 AM
Terminations	Termination Effective Date	Insert	New Registration			10/30/2018 11:57 AM
Terminations	Termination Reason	Insert	New Registration			10/30/2018 11:57 AM